Clinical use of selective decontamination: the concept.
Infections can be classified according to: (1) the type of offending microorganism (virus, bacteria, fungi, parasites), (2) according to the clearance by the defence system (T cell dependent/independent) and (3) in case bacteria are the causative agents in Gram-positive and Gram-negative infections. The latter classification in Gram-positive and Gram-negative infections has appeared to have a practical consequence. Gram-negative bacteria, often involved in major infections and yeasts, appear to play practically no role in the intestinal ecological system. Consequently, it is nowadays increasingly attempted to eliminate Gram-negative bacteria and yeasts selectively from the digestive tract with antimicrobial agents. Selective suppression of Gram-positive bacteria may severely affect the ecosystem of the digestive tract. This selective suppression of Gram-negatives must be continued as long as patients are immunocompromised (locally or systemically) and is called selective decontamination of the digestive tract.
van der Waaij
D
D
Laboratory for Medical Microbiology, University of Groningen, The Netherlands.
Manson
W L
WL
Arends
J P
JP
de Vries-Hospers
H G
HG
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology; D004066:Digestive System Diseases / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology; D004352:Drug Resistance, Microbial; D006090:Gram-Negative Bacteria; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000150:complications*
D000900:Anti-Bacterial Agents